Preterm birth and maternal smoking in pregnancy are strong risk factors for aortic narrowing in adolescence

Bonamy, Anna‐Karin Edstedt; Bengtsson, Johan; Nagy, Zoltán; Keyzer, Hans De; Norman, Mikael

doi:10.1111/j.1651-2227.2008.00890.x

Cited by 57 publications

(27 citation statements)

References 33 publications

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“…Baseline echocardiographic results were similar to those in previously published studies [14,15] which revealed smaller heart (LV, RV and LA) dimensions in the group of ELBW children than in the control group. After expressing the results as z-scores for BSA, statistically significant differences were observed for diastolic diameters of both ventricles and the volume of the left one.…”

Section: Discussionsupporting

confidence: 81%

From a Regional Cohort of Extremely Low Birth Weight Infants: Cardiac Function at the Age of 7 Years

et al. 2013

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Background: The long-term impact of prematurity on cardiac structure and function has not yet been fully discovered. Objectives: To assess long-term cardiac complications in the regional cohort of extremely low birth weight (ELBW) children born in 2002-2004. Material and Methods: Eighty-one children born as ELBW infants (91% of the available cohort) with a median birth weight of 890 g (25-75th percentile: 760-950) were evaluated at the mean age of 6.7 years. The control group included 40 children born full-term, selected from one general practice in the district. Echocardiography and 24-hour ambulatory blood pressure measurements (ABPM) were performed. The primary outcome variable was the presence of cardiac complications such as left ventricular hypertrophy (LVH), diastolic dysfunction or systolic dysfunction. Results: LVH was diagnosed in 4/81 ELBW children and 2/40 control children (p = 1.0). Concentric remodeling was detected in 8 (10%) subjects from the ELBW group and in 2 (5%) from the control group (p = 0.49). There were no patients with diastolic or systolic dysfunction in either group. After having expressed the results of M-mode echocardiography as z-scores for body surface area (BSA), statistically significant differences were observed for right-ventricle dimension in diastole (-1.49 ± 1.25 vs. -0.31 ± 0.91; p < 0.001), LV inner dimension in diastole (-0.53 ± 1.26 vs. 0.13 ± 0.94; p = 0.01) and left atrium (-0.93 ± 1.07 vs. -0.15 ± 1.02; p < 0.01). Heart rate (HR) was significantly faster in ELBW children (92.9 ± 8.4 vs. 86.7 ± 7.4 bpm; p = 0.01 adjusted for BSA) and they also had significantly higher night-time blood pressure [mean (z-score): 1.15 vs. 0.2; p = 0.02] without nocturnal dipping (night-time dipping <10%: 13 (16.7%) vs. 2 (5.2%), p = 0.13). Conclusions: No differences were found between the groups in the occurrence of cardiac complications. Ex-preterm ELBW children at age 6 may have a faster HR, smaller cardiac dimensions on echocardiography and higher nocturnal blood pressure. The clinical relevance of these findings is unknown.

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Section: Discussionsupporting

confidence: 81%

From a Regional Cohort of Extremely Low Birth Weight Infants: Cardiac Function at the Age of 7 Years

et al. 2013

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“…Several studies have demonstrated higher BP in children and young people born preterm, although the effects of gestational age, birthweight and intrauterine growth on later BP varied between studies . It is clear that the early life environment may trigger structural and functional changes in cardiovascular, metabolic and neuroendocrine function that persist throughout life .…”

Section: Discussionmentioning

confidence: 99%

“…A control group of 125 children, born at full term, was assembled from a population‐based register and matched according to birth date, birth hospital and gender. In 2005 and 2006, study subjects and controls were invited to participate in one or two MRI studies that were performed at the same time, one investigating the brain and one measuring the aorta . This meant that 76 of the 182 VLBW children underwent an MRI examination at the age of 12–17 years.…”

Section: Methodsmentioning

confidence: 99%

Preterm birth may be a larger risk factor for increased blood pressure than intrauterine growth restriction

et al. 2015

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“…An initial study conducted by Edstedt Bonamy et al examined adolescent girls born preterm (≤34 weeks’ gestational age) and reported narrower, but more compliant abdominal aortae and lower peripheral skin blood flow compared with girls born at term. Follow‐up MRI analysis conducted in preterm adolescent boys and girls demonstrated a 16% narrowing in the thoracic aorta and a 19% narrowing of the abdominal aorta in the individuals born preterm, after correcting for body size and gender . There was also a 7% mean reduction in the number of capillaries per mm 2 of skin in the fingertip (as assessed using intra‐vital microscopy), which likely accounts for the reduced peripheral skin blood flow .…”

Section: Introductionmentioning

confidence: 94%

“…Of concern, there is now increasing evidence linking preterm birth with an increased risk of cardiovascular disease as the first survivors of very and extremely preterm birth reach early adulthood. Numerous studies have reported that preterm birth is a strong risk factor for increased arterial pressure in children , adolescents , young adults and older adults . This is of considerable clinical relevance given that elevated arterial pressure is a major risk factor for the development of cardiovascular disease and adverse cardiovascular events such as myocardial infarction and stroke .…”

Section: Introductionmentioning

confidence: 99%

The effects of preterm birth and its antecedents on the cardiovascular system

Bensley

Matteo

Harding

et al. 2016

Acta Obstet Gynecol Scand

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Introduction. Preterm birth occurs in approximately 10% of all births worldwide. It prematurely exposes the developing cardiovascular system to the hemodynamic transition that occurs at birth and to the subsequent functional demands of life ex utero. This review describes the current knowledge of the effects of preterm birth, and some of its common antecedents (chorioamnionitis, intra-uterine growth restriction, and maternal antenatal corticosteroid administration), on the structure of the myocardium. Material and methods. A thorough literature search was conducted for articles relating to how preterm birth, and its antecedents, affect development of the heart. Given that sheep are an excellent model for the studies of cardiac development, this review has focused on experimental studies in sheep as well as clinical findings. Results. Our review of the literature demonstrates that individuals born preterm are at an increased risk of cardiovascular disease later in life, including increased mean arterial pressure, abnormally shaped and sub-optimally performing hearts and changes in the vasculature. The review highlights how antenatal corticosteroids, intra-uterine growth restriction, and exposure to chorioamnionitis also have the potential to impact cardiac growth in the preterm newborn. Conclusions. Preterm birth and its common antecedents (antenatal corticosteroids, intra-uterine growth restriction, and chorioamnionitis) have the potential to adversely impact cardiac structure immediately following birth and in later life.

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Preterm birth and maternal smoking in pregnancy are strong risk factors for aortic narrowing in adolescence

Cited by 57 publications

References 33 publications

From a Regional Cohort of Extremely Low Birth Weight Infants: Cardiac Function at the Age of 7 Years

From a Regional Cohort of Extremely Low Birth Weight Infants: Cardiac Function at the Age of 7 Years

Preterm birth may be a larger risk factor for increased blood pressure than intrauterine growth restriction

The effects of preterm birth and its antecedents on the cardiovascular system

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